Value Of Medical Thoracoscopy Research Articles

Malignant pleural mesothelioma: diagnostic value of medical thoracoscopy and long-term prognostic analysis

BackgroundMalignant pleural mesothelioma (MPM) is marked by its difficult diagnosis and poor prognosis. Medical thoracoscopy (MT) is an effective and safe procedure for the diagnosis of exudative pleural effusions and many factors associated with poor prognosis of MPM. We conducted this study to investigate the value of MT for diagnosing of MPM and to identify prognostic factors for MPM patients.MethodsFrom July 2005 through June 2014, a total of 833 patients with undiagnosed pleural effusions underwent MT and pleural biopsies were taken. Clinical data of all patients with MPM were retrospectively analyzed, and those with complete follow-up data were analyzed for prognostic factors.ResultsEventually, MPM was the final diagnosis in 40 patients. Diagnostic efficiency of MT for MPM was 87.5%, since diagnosis of MPM failed to be established in 5 patients during the initial MT. Median survival was 17.1 mo (95% confidence interval: 13.6–20.7 mo). MT findings of pleural adhesion and plaques were adverse prognostic factors for MPM. In addition, old age, male gender, smoking history, histological type, poor staging, no treatment, low total protein level in pleural fluid, and computed tomographic findings such as pulmonary consolidation or infiltration, mediastinal lymphopathy, pulmonary mass or nodules, and pleural nodularity were also poor prognostic factors for MPM.ConclusionsMT is safe with a high positive rate in the diagnosis of MPM, and pleural adhesion and plaques seen under MT may be the adverse prognostic factors for MPM. Multiple clinical characteristics can affect the survival of MPM patients.

Medical thoracoscopy in China-the present status and the future.

Medical thoracoscopy (MT) refers to a minimally invasive procedure to inspect and perform a biopsy of the pleural space, as well as to perform therapeutic interventions, in a nonintubated patient under local anesthesia. This procedure provides the physician a window into the pleural space. Over the past two decades, MT has been developed very rapidly in China. We performed a review of the published data on MT in China, and estimated the present status, the challenges, and future perspectives of MT. From the data we conduct that MT is widely used well in China, not only in the diagnosis of exudative pleural effusions, but also in the management of pleural diseases, such as tuberculous pleural effusion, malignant pleural effusion and spontaneous pneumothorax. Meanwhile, it is noteworthy that few prospective clinical trials, lack of routine follow-up of MT are current domestic problems for diagnosis and management in pleural effusion. Consequently, more prospective, randomized clinical trials are needed to assess the diagnostic value and treatment superiorities of MT compared with traditional methods or other subjects in China in the future.

The diagnostic value of medical thoracoscopy for unexplained pleural effusion

To explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy. A retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy. The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed. Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

Analysis of medical thoracoscopy in the diagnosis and treatment of tuberculous pleuritis effusion

Objective To explore the value of medical thoracoscopy in the diagnosis and treatment of tuberculous pleuritis. Metheda 31 patients with tuberculous pleuritis in our hospital were analyzed retrospectively from January 2004 to December 2008. Of the those 10 patients were given medical thracoscopy with closed thoracic drainage as treatment group and 21 patients were given conventional pleuracentesis repeatedly after pleuralbiopsy or given pleural fluid drainage with deep venous catheter as the control group. Results All patients (100%) in the treatment group and 11 patients(52.38%) in the control group obtained the pathological final diagnosis. There was significant difference between the two groups in the detection rates(P O.05).Conclusion Medical thoracoscopy is a simple,fast effective method in the diagnosis and treatment of the patients with tuberculous plerritis in the earlier period. Key words: Medical thoracoscopy; Tuberculous pleuritis; Pleuralbiopsy; Diagnesis; Treatment

Diagnostic value of medical thoracoscopy in pleural disease: a 6-year retrospective study

Diagnostic value of medical thoracoscopy in pleural disease: a 6-year retrospective study